Double Appendix Research Articles

Acute appendicitis in twin appendices: case report

<p class="abstract">A double appendix is a rare congenital malformation with a frequency ranging from 0.004 to 0.009% and only a small percentage of instances presenting as appendicitis. Although the cause of appendiceal duplication is unknown, it poses a difficult clinical picture in patients with right lower quadrant pain. In this case report, we presented two cases of operative treatment of acute appendicitis in a doubled vermiform appendix in 4 and 17 years old male patients. Both cases did not have any pertinent prior medical condition and presented with shifting right lower quadrant (RLQ) abdominal pain associated with nausea, vomiting and anorexia. Clinical exam, laboratory investigations as well as imaging findings were consistent with features of acute appendicitis. In both patients, the diagnosis of the duplicated appendices was unsuspected until two tubular structures arising from the cecal wall were discovered intraoperatively and confirmed on histopathological examination after appendectomy of the two appendices was performed. Hence, in all situations where acute appendicitis is suspected clinically and radiologically, surgeons must maintain a high level of suspicion for the potential of duplicated appendices to avoid missing the duplication and resulting post-operative difficulties and medicolegal concerns.</p>

Double appendix with appendicitis: case report

The frequency of doubling of the appendix, according to the literature, is about 0.004% of the number of appendectomies. According to the literature, there were about 100 cases, of which 15 were complicated by the acute form. Doubling can be partial, complete or of several types: a shoot in the form of a double-barreled gun; "avian" in which there are two developed processes located on both sides of the cecum; and one process is located in its usual place, and the other, as a rule, rudimentary, is located along one of the muscle bands. Doubling of the appendix can be in the cecum or in the duplication of the cecum. It was first described and systematized in 1936 by Cave, then in 1962 by Wallbridge, then in 1993 by Biermann.

Tubular colonic duplications

Abstract Introduction Duplicated colon is either cystic or tubular; it is a rather unusual clinical entity that remains asymptomatic and undiagnosed in most cases. For Diagnosed cases, excision of the duplicated part is indispensable, due to reported risk of malignancy. Case presentation We report two cases of colonic duplication in female children with a double anus (vestibular anus and normal site anus); one of them had total double-barreled large intestinal duplication with a double appendix without any communication of both lumens, which is a rare finding. The other case had Y-shaped Rectosigmiod duplication. No genitourinary and other organ duplication detected. Conclusion When the female infant presented with the double anus, predictably colonic duplication should be considered. The precise and relevant technique should be tailored during management. Informed consent has been taken for publishing the article.

El Códice Calixtino de la catedral de Santiago de Compostela

Calixtinus Codex is an illuminated manuscript from the mid-twelfth century that is kept in the Chapter Archive of the Cathedral of Santiago de Compostela. It consists of five books and two appendices, with a total of 225 parchment sheets written on both sides. The first is of a liturgical nature, it contains sermons, hymns, prayers and other texts for the celebration of the festival of St James the Greater. The second is a collection of twenty miracles wrought by the Apostle. The third contains the story of the translation of the remains of St James. The fourth book contains the story of Turpin, Archbishop of Reims, accompanying Charlemagne in the reconquest of northern Spain. The fifth is the oldest guide for pilgrims on their way to Santiago de Compostela; it describes the way, people, local customs, churches and works of art. And most of all describes the Santiago Cathedral and the city of Santiago as the pilgrim could see in the twelfth century. A final double Appendix includes other liturgical texts, hymns and musical pieces dedicated to St James the Greater. Although sometimes referred to as Liber Sancti Calixtino – Codex Iacobi, the two concepts are not identical. The Liber Sancti Iacobi represents the contents of the book, a collection of texts related to St James the Greater, which several manuscripts, the most notable of which is the Codex Calixtinus kept in the cathedral of Santiago de Compostela.

Bifid Vermiform Appendix: A Case Report

Appendiceal anomalies are extremely rare: they have a reported incidence of between 0.004% and 0.009% of appendectomy specimens. The authors report a case of a patient who was found to have 2 appendices at emergency laparotomy, review the classification system used, and discuss the potential clinical pitfalls of similar cases. A 23-year-old man was admitted as an emergency with abdominal pain and vomiting. The operative finding was of a bifid appendix. One appendix was grossly gangrenous and lacked a mesoappendix, whereas the other had a mesoappendix and appeared macroscopically normal. The appendices shared a common base that arose from the cecum in the typical anatomical position. No other intra-abdominal malformations were present at inspection during laparotomy. Histology confirmed features of gangrenous appendicitis. His postoperative recovery was uneventful, and he was discharged after 4 days. Although rare, it is important for several reasons that surgeons are aware of the potential anatomical anomalies and malpositions of the vermiform appendix: first, a missed second appendix may result in serious clinical and medico-legal consequences; second, a double appendix can be confused with other intra-abdominal conditions; and finally, they can be associated with other congenital abnormalities.

Appendix vermiformis duplex — a lesson for the unwary

Appendix vermiformis duplex is a rare phenomenon. A case of a double appendix with one caecum and inflammation of one of the appendices is presented. The unusual presentations of the anomaly can cause diagnostic dilemmas. Awareness of a duplication is important, as failure to recognise the condition may lead to clinical problems and possible litigation.

APPENDIX VERMIFORMIS DUPLEX

The appendix is such a common surgical specimen that one hardly anticipates the possibility of its duplication. However, although it is a very rare anomaly, the so-called double appendix does occur, and it offers a number of interesting points for consideration. The first question which naturally arises is: What is an appendix, and what are the criteria by which one may identify the organ and separate it from other types of protrusions from the cecum? Cave, in an extensive summary of the knowledge of the comparative anatomy of this region, concluded, contrary to common belief, that a true vermiform appendix identical to that met with in man is found only in gibbons and anthropoid apes, although, peculiarly enough, monotremes and some marsupials possess a strikingly similar structure. Aside from its gross form and position, histologically the appendix is identified and distinguished from the cecum by the amount and arrangement of

"DOUBLE APPENDIX" ASSOCIATED WITH OTHER CONGENITAL ANOMALIES

The following case is presented because it is believed to be the first reported instance of double appendix arising as a congenital malformation and unassociated with inflammation. This and other anomalies of the intestinal tract in the patient bear a striking resemblance to the avian alimentary tract. Double appendix appears in quotation marks, for the are believed to be the homologs of avian ceca rather than true appendixes. The possibility of two appendixes in one person may have important medicolegal significance. A summary of the clinical data and a condensation of the pathologic report follow: REPORT OF CASE History .—L. A., a white male infant, entered the hospital on July 29, 1931, at the age of 11 hours, because of an imperforate anus. He was born at full term; the delivery was normal. X-ray plates taken with the patient in an inverted position showed no air-filled intestine in the